Water Seal Drainage Research Articles

Efficacy of slow negative pleural suction in thoracic trauma patients undergoing tube thoracostomy–A randomised clinical trial

IntroductionThoracic injuries are prevalent in polytrauma patients, with road traffic accidents being a major cause. In India alone, over 400,000 people were injured in such accidents in 2022. Rib fractures, haemothorax, and pneumothorax are common chest injuries, often managed with tube thoracostomy. While standard procedures for chest tube placement are established, consensus on post-insertion management, particularly regarding negative pleural suction, is lacking. Research on this topic mostly pertains to planned thoracotomies rather than trauma cases. This study seeks to compare outcomes of slow negative suction versus conventional drainage in blunt or penetrating thoracic trauma. MethodsThis single-centre, open-label, randomized controlled trial in a western Indian hospital from Jan 2021 to June 2022 included adult patients with thoracic trauma requiring intercostal drainage tubes. Patients needing emergency thoracotomy, mechanical ventilation, or bilateral chest tubes were excluded. Sample size (n = 64) was calculated based on prior studies. Patients were randomly assigned to experimental (slow negative pleural suction) or control (conventional water seal drainage) groups. Both groups received standard care. Primary outcome was time to chest tube removal; secondary outcomes included hospital stay length, complications, and need for further intervention. Data were analysed using SPSS. Significance was set at p < 0.05. ResultsDuring the study 64 patients were randomised into experimental (n = 32) or conventional (n = 32) groups. Most of the patients were males (88 %, n = 56). Both groups had similar baseline characteristics. Experimental group patients had shorter median chest tube duration (3 [IQR 2–3.75] vs. 5 [3–8.75] days, p < 0.001) and hospital stay (5 [4–8.75] vs. 10 [6–16.75] days, p = 0.004). No discomfort was reported with slow continuous negative pleural suction. Mortality was 1 (3 %) in the experimental group vs. 2 (6 %) in the conventional group. Four patients suffered retained haemothorax, with only one occurrence in the experimental group (3 %). ConclusionApplication of slow continuous negative pleural suction to chest tubes in patients of thoracic trauma can decrease the chest tube duration and the hospital stay. This study ought to be followed up with multicentric randomised clinical trials with larger sample sizes to better characterise the effects of slow continuous negative pleural suction.

Successful Autologous Blood Patch Pleurodesis: A Safe and Useful Treatment for Persistent Pneumothorax in Former Pulmonary Tuberculosis and Aspergillosis in Pregnant Women

Background: Autologous Blood Patch Pleurodesis (ABPP) is one of the treatment options for persistent pleural air leaks especially in patients who are not suitable for surgical intervention. Persistence pneumothorax is defined as pneumothorax of more than five days duration. It is associated with increased morbidity and cost of care. The most widely accepted treatment for it is pleurodesis. Several types of pleurodesis have been proposed, including surgical approaches and the instillation of different chemicals in the intrapleural space. ABPP has proven to be a simple, inexpensive, efficacious and safe method. We present the case of the first patient with Persistent Pneumothorax we have treated Successfully with ABPP. ABPP is currently rarely and uncommonly used, but it provides benefits especially in special conditions with easier, cheaper, and quite effective procedures.&#x0D; Case: A female 35-year-old pregnant women patients with Former Tuberculosis (FTB) come to our hospital with complaints breathlessness and chest pain worsening since 3 days before admitted to our hospital. Chest radiography showed spontaneous pneumothorax with GeneXpert (GE) sputum Mtb Not Detected but there is Aspergillosis from Fungal Culture. Water Sealed Drainage (WSD) was inserted in right pleural for almost 1 month and this patient discharge with pneumostat. One month after that she come again with Persistence Pneumothotax, so that we do the pleurodesis with Blood Patch and get the improvement from clinical status. Antifungals are continued for an initial 4-6 weeks while an outpatient evaluation is conducted.&#x0D; Conclusion: ABPP is a safe, inexpensive and efficacious treatment for persistent pleural air leak. Autologous Blood Patch administration may be considered for patients with Persistent Pneumothorax.

Recurrent Pneumothorax in a Patient with Post-Tuberculosis Sequelae: A Case Report

Introduction: Tuberculosis and its complications could lead to a condition with a high mortality and morbidity in which those complications include hemoptysis, pleural effusions, post tubercular lung disease and spontaneous pneumothorax. Pneumothorax in one possible complication in pulmonary tuberculosis with an incidence rate up to 1.5%.&#x0D; Case: A 46 years old man came to emergency room due to shortness of breath that had been felt since one week before and worsened after lifting some weight things 30 minutes prior the admission, the shortness of breath was described as heavy sensation whenever patient breaths, this complaint was accompanied by pain in the right lung, he has a history of lung tuberculosis and had completed his treatment, radiology examination showed right pneumothorax and later patient was hospitalized for a week with Water Seal Drainage (WSD) placed in his right lung. One month later, patient came back to emergency room with the same symptoms and was hospitalized again, but this time, pleurodesis was done.&#x0D; Discussion: Tuberculosis causes damage to lung structure, and disturb its function leaving a sequelae and causing disability called post-tuberculosis lung disease (PTLD). Secondary spontaneous pneumothorax is pneumothorax that occurring in a setting of underlying lung disease. Patients with SSP tolerate pneumothorax less well and display heavier symptoms, even if the pneumothorax is relatively small in size.&#x0D; Conclusions: The inflammation and fibrosis process on Tuberculosis infection leaves a sequelae damage and increased the vulnerability of someone lung’s that could lead to many complications such as pneumothorax.&#x0D; Key words: Pneumothorax, Post-Tuberculosis Sequelae, Recurrent.

Comparison between use of a pleural drainage system with flutter valve and a conventional water-seal drainage system after lung resection: a randomized prospective study.

There is still a debate regarding the most appropriate pleural collector model to ensure a short hospital stay and minimum complications. To study aimed to compare the time of air leak, time to drain removal, and length of hospital stay between a standard water-seal drainage system and a pleural collector system with a unidirectional flutter valve and rigid chamber. A randomized prospective clinical trial was conducted at a high-complexity hospital in São Paulo, Brazil. Sixty-three patients who underwent open or video-assisted thoracoscopic lung wedge resection or lobectomy were randomized into two groups, according to the drainage system used: the control group (WS), which used a conventional water-seal pleural collector, and the study group (V), which used a flutter valve device (Sinapi® Model XL1000®). Variables related to the drainage system, time of air leak, time to drain removal, and time spent in hospital were compared between the groups. Most patients (63%) had lung cancer. No differences were observed between the groups in the time of air leak or time spent hospitalized. The time to drain removal was slightly shorter in the V group; however, the difference was not statistically significant. Seven patients presented with surgery-related complications: five and two in the WS and V groups, respectively. Air leak, time to drain removal, and time spent in the hospital were similar between the groups. The system used in the V group resulted in no adverse events and was safe. RBR-85qq6jc (https://ensaiosclinicos.gov.br/rg/RBR-85qq6jc).

HIDROPNEUMOTHORAKS ET CAUSA TB PARU

Hydropneumothorax is a condition where there is air and fluid in the pleural cavity resulting in the collapse of lung tissue. The exact incidence is unknown but it is found that the incidence of pneumothorax ranges from 2.4 to 17.8/100,000 population per year. In this case, a 42-year-old man with complaints of chest pain since 2 weeks before admission to the hospital. The complaints included shortness of breath and continuous coughing. From the examination results obtained BP 120/80, HR: 135x/I, RR: 18 x/I, and temperature: 37oC. Physical examination found asymmetrical chest movements, chest tube in the sinistra thorax, weak vocal fremitus in the basal part of the left hemithorax at the level of posterior ICS XI, hypersonor in the right lung at the level of ICS II-IV and dimmed in the left basal part at the level of ICS V and a decrease in left lung breath sounds. X-ray examination showed an area of lusensi without pulmonary scars in the lateral aspect of the sinistral hemithorax with a ridge in the basal aspect of the sinistral hemithorax accompanied by an air fluid level in the left hemithorax. The patient was diagnosed with hydropneumothorax ec pulmonary tuberculosis with water seal drainage.

Assessment of Rare Case on Patient with Filariasis-Associated Bilateral Pleural Effusion

Bilateral pleural effusion is fluid accumulation in both lungs of pleural spaces. The clinical manifestations of bilateral pleural effusion (chylothorax) caused by filariasis are so rare that they are often challenging to diagnose. This case study described a 21-year-old woman, domiciled in Sumatra, with complaints of shortness of breath and swollen legs. Radiological examination results found bilateral pleural effusion. Initially, it was suspected that the effusion was caused by tuberculosis, Systemic Lupus Erythematosus (SLE), and malignancy; however, treatments for these did not improve the patient’s condition. A Water Seal Drainage (WSD) was inserted and a chylous or chylothorax pleural effusion was obtained, and microfilaria was founded in the nocturnal blood examinations. Oxygen and nursing interventions were administered using lung expansion and postural drainage techniques, supported by education on effective coughing and deep breathing, along with the fulfillment of nutritional needs and dietary adjustments.

Dry suction water seal system for management of pericardial fluid during epicardial ablation.

Epicardial ablation is an important approach in the management of patients with complex ventricular arrhythmias. Irrigated ablation catheters present a challenge in this potential space due to fluid accumulation that can cause hemodynamic compromise, requiring frequent manual fluid aspiration. In this series, we report our initial experience with the use of a dry suction water seal system for pericardial fluid management during epicardial ablation. Consecutive patients undergoing epicardial ventricular tachycardia (VT) ablation at a single center were included. All patients underwent epicardial access via a subxiphoid approach with a single operator. A deflectable sheath was advanced into the pericardial space, and the side port was attached to a dry suction water seal system attached to wall suction at -20 mmHg. Procedural information including patient characteristics, outcomes, and adverse events. After a period of initial experience, pericardial fluid infusion and aspiration volumes were recorded. Eleven patients were included in this series. All patients underwent epicardial ablation with complete success achieved in 8 of the 11 patients and partial success in the remaining patients. Pericardial fluid intake ranging from 485 to 3050 mL with aspiration of 350-3050 mL using the dry suction water seal system. No adverse events occurred. Dry suction water seal drainage systems can provide a safe strategy for efficient pericardial fluid management during epicardial VT ablation, potentially shortening procedure duration.

Pneumothorax occuring during the final stage of treatment in miliary tuberculosis patients

Air in the pleural space can cause lung collapse and respiratory discomfort, which can be life-threatening in very ill patients, making pneumothorax a medical emergency. Since tubercle bacilli can travel through the blood to the lungs and other organs, Miliary Tuberculosis (TB) is a disseminated disease that can be lethal. We present a case of a 36-year-old male with Pneumothorax Occuring during the Final Stage of Treatment in Million Tuberculosis Patients. The patient is currently undergoing outpatient treatment of miliary TB for the 11th month and so far his condition is getting better, however was admitted to the emergency unit of the hospital, diagnosed with left pneumothorax based on clinical, laboratory, and radiology showing. In meanwhile, 88% of the room air was saturated with oxygen, necessitating Intensive Care Unit treatment with HFNC FiO2 100 Flow 60, followed by high consentration oxygen therapy with a non-rebreathing mask (NRM) of 15 litres/minute. Combivent inhalation and pulmicort inhalation were given every 15 minutes. The family refused to install a water sealed drainage or chest tube in the patient. The patient was also given treatments with ceftriaxone, citicolin, methylprednisolone, omeprazole and the advanced phase of tuberculosis drugs namely Rifampicin 450 mg and Isoniazid 300 mg. On the 6th day of treatment in the ICU, the patient's condition improved and the pneumothorax decreased. In this case, the likelihood of Pneumothorax in patients with miliary tuberculosis needs to be emphasized, as well as the importance of evaluation and strict follow-up to prevent the occurrence of pneumothorax.

A STUDY ON INTERCOSTAL CHEST TUBE IN PATIENTS WITH PNEUMOTHORAX IN A TERTIARY CARE CENTRE: A RETROSPECTIVE STUDY

Background : Pneumothorax is the accumulation of air within the pleural space, i.e within two layers of the pleura. It may occur spontaneously due to underlying lung pathology or due to trauma in various forms. Spontaneous pneumothorax is further classied into primary and secondary depending on the etiological ndings. Intercostals water sealed drainage system, commonly known as chest tube, are designed to remove air or uid from the pleural cavity which accumulates due to various etiologies and has been used for the management of pneumothorax for a long time. This is a retrospective observational study made on 50 p Methods : atients who presented with pneumothorax due to various causes and were managed by chest tube drainage in a tertiary care hospital. Results and observations : Of 50 patients, 46 patients (92%) had successful outcome. However the p-value came out to be 0.64 (&gt; 0.05), hence the role of chest tube in primary management of pneumothorax is ruled out. The initial management of pneumothorax is conservative with observatio Conclusion : n and needle aspiration. Chest tube drainage should be considered only when conservative measures fail and clinical and radiological parameters suggest deterioration, since the more invasive method as primary treatment causes more complications

The impact of suction addition to simple water seal on the outcomes after pulmonary surgery: A meta-analysis.

Chest tube drainage during pulmonary surgery is fundamental to removing air and fluid, as well as for lung re-expansion. However, the advantages of adding external suction to the water seal are under debate. The aim of the study was to conduct a meta-analysis in order to assess the effects of adding suction to a simple water seal on the outcomes of lung surgery. A search of the literature up to November 2021 found 14 studies with 2449 lung surgery patients. Of these patients, 1092 received suction drainage and 1357 received a simple water-seal drainage. The studies reported the effects of adding suction to a simple water seal on postoperative outcomes after lung surgery. A randomor fixed-effect model determined the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (95% CIs) to compare the outcomes. In patients undergoing lung surgery, suction resulted in a substantially longer chest tube duration (MD = 0.74, 95% CI: 0.90-1.40, p = 0.03, Z = 2.21) and a smaller postoperative pneumothorax (OR = 0.27, 95% CI: 0.13-0.59, p = 0.02, Z = 2.24) than a simple water seal. However, no differences existed in prolonged air leak (p = 0.91, Z = 0.12), air leak duration (p = 0.28, Z = 1.07) or length of hospital stay (p = 0.23, Z = 1.2) between the 2 approaches. Suction led to considerably longer chest tube duration and lower postoperative pneumothorax, but no significant difference in sustained air leak, air leak duration or length of hospital stay was observed compared to a simple water seal in patients undergoing pulmonary surgery. Further research is needed to validate these findings and increase confidence, particularly regarding the postoperative pneumothorax results.

Patients’ Perceptions of Experiences of Postoperative Chest Drain Tube Insertion: A Pilot Survey

Pleural drainage is a routine procedure conducted after thoracotomy and thoracoscopy. It is used to remove air or excess fluid from a pleural cavity and enables proper lung expansion. Essential elements of care provided during hospitalization and treatment include meeting patients' growing expectations and continually improving quality while optimizing safety. This study aimed to explore patients' experiences with pleural drainage after thoracic surgery and their correlation with socio-demographic data. A pilot survey with an exploratory design was conducted at a large teaching hospital in Poland, in the Department of Thoracic Surgery at the University Clinical Centre in Gdansk. The study involved the analysis of 100 randomly selected subjects with a chest tube drain. A self-designed questionnaire was used to collect social, demographic, and clinical data. Twenty-three questions related to experiences with pleural drainage, ailments, limitations in daily functioning, and security with a chest tube were evaluated using a 5-point Likert scale. Patients completed the questionnaire on the third postoperative day. Individuals fitted with a traditional water-seal drainage system felt safer than those from the digital drainage group (p = 0.017). Statistically significant differences were found in the assessment of nursing assistance (p = 0.025); the number of satisfied patients was greater in a group of unemployed people. No correlation was found between demographic and social factors and the patients' sense of security (gender: p = 0.348, age: p = 0.172, education level: p = 0.154, professional activity: p = 0.665). Demographic and social characteristics did not significantly affect patients' sense of safety with chest drainage types. Patients with traditional drainage felt significantly safer than patients with digital drainage. Patient knowledge of pleural drainage management was not satisfactory, with a number of patients indicating a lack of knowledge in this area. This is important information that should be considered when planning measures to improve the quality of care.

A rare case series of bilateral pneumothorax among adult COVID-19 patients reported at a tertiary care hospital in Mizoram, India

Apart from routine symptoms such as fever, cough, sore throat, myalgia, and dyspnea in severe form of Coronavirus Disease-2019 (COVID-19) infection, very rarely patients can develop worsening of dyspnea due to bilateral pneumothorax. The present case series is about five adult patients, of age ranging from 39 to 57 years, who developed bilateral pneumothorax during their stay in the hospital. All the cases were reported between May 2021 and October 2021 and were tested positive for COVID-19 by reverse transcriptase polymerase chain reaction. Out of five adults, three patients were males and were two females. All the patients were assessed with quick sequential organ failure assessment (q SOFA) score on admission and then monitored by SOFA Score. On admission, baseline contrast enhanced computer tomography chest was done for three patients, and chest radiography for one patient all showing features of moderate to severe COVID-19 pneumoniae. One patient with q SOFA Score of 3 on admission required immediate invasive mechanical ventilatory support with ultrasonogram chest immediately performed showing bilateral pneumothorax. Patients were started on remdesivir, dexamethasone, low molecular weight heparin or unfractionated heparin, tocilizumab, and antibiotics. Subsequently, during the course of stay in the hospital, rest of the four patients developed symptoms of pneumothorax and emergency bedside chest ultrasonography showed the typical barcode or stratosphere sign confirming bilateral pneumothorax. All the patients were managed with bilateral chest intercostal water seal drainage intercostal drain tube and invasive mechanical ventilation. Fraction of Inspired Oxygen (FIO2), and other ventilatory settings were adjusted depending on daily arterial blood gas findings. Attempts to wean off from ventilatory support and extubation were successful for two patients, whereas three patients did not survive. In this case series, we will be presenting about those five cases of bilateral pneumothorax in COVID-19 patients reported at a tertiary care hospital in Mizoram, India.

Optimal Chest Drainage Method After Anatomic Lung Resection: A Prospective Observational Study

BackgroundSeveral methods for chest drainage after pulmonary resection of malignant lung tumors exist, but consensus on the ideal method has not been reached. MethodsWe conducted a multicenter prospective observational study. We enrolled 2200 patients who underwent lung resection for lung tumors. Of the 1470 patients who underwent anatomic resection, 347 showed air leak on the morning of postoperative day 1. They were assigned to 3 groups according to the chest drainage method on postoperative day 1. ResultsOf 347 patients with postoperative air leaks, 107 (30.8%), 179 (51.6%), and 61 (17.6%) were assigned to water seal, continuous suction, and digital drainage, respectively. The median postoperative air leak duration was significantly longer with digital drainage (4.0 days) than with either water seal (2.5 days) or continuous suction (3.0 days; P = .009). Chest tubes were required for significantly more days on average with digital drainage (6.0 days) than with water seal (4.0 days) or continuous suction (4.0 days; P = .003). Prolongation of air leak duration was significantly more likely to occur in patients with body mass index <18.5 kg/m2 (hazard ratio [HR], 1.6; 95% CI, 1.1-2.3), moderate or severe air leak on postoperative day 1 (HR, 2.0; 95% CI, 1.5-2.6), or digital drainage (HR, 1.4; 95% CI, 1.01-1.9). ConclusionsWater seal was associated with significantly shorter duration of postoperative air leak and chest drainage compared with continuous suction and digital drainage.

BILATERAL PNEUMOTHORAX IN LUNG METASTASES OF BREAST CARCINOMA: A CASE REPORT

Introduction: Bilateral pneumothorax is a rare case which happens in 1.3 to 1.9 percent of all cases of pneumothorax.1 In breast carcinoma patients, it is due to lung metastasis and first selected conservative therapy.2 Lung metastasis can be found in the appearance of pulmonary nodules called cannon-ball metastases in chest X-Ray (CXR).3 Method: Case report based on findings in chest X-Ray. Result: A 42 year-old female came to ER with sudden shortness of breath and pleuritic pain. She was diagnosed with breast carcinoma 3 years prior the ER visit and had undergone mastectomy on breasts and chemotherapy. Physical examination showed bilaterally decreased breath sounds. CXR AP postion showed bilateral pneumothorax and multiple nodules varied in size indicated lung metastases. Chest tubes with water-sealed drainage were inserted in both side of the lungs. CXR after the insertion showed reduction of the volume of pneumothorax in both side of the lungs and cannon-ball metastases in both sides of the lungs. CXR was performed serially until hospital discharge. Discussion: Bilateral pneumothorax which develops in patients who have history of breast carcinoma is considered very rare.It is caused by the metastatic process and treatment.2 CXR can be used to detect the metastasis and its complications such as pneumothorax.4 Conclusion: Bilateral pneumothorax is rarely seen in patients with breast carcinoma. Early detection of lung metastasis and appropriate therapy of tumor can prevent complications such as pneumothorax.Keywords: bilateral pneumothorax; lung metastases; breast carcinoma; chest X-Ray

A Deadly Spontaneus Hemopneumothorax: A Case Report

Background: Spontaneous hemopneumothorax (SHP) is a subtype of hemopneumothorax in which there is an accumulation of blood and air in the pleural space without trauma or other definitive cause. Spontaneous hemopneumothorax is a rare disease.&#x0D; Case presentation: A man, aged 32 years, came with a complaint of sudden shortness of breath due to a right hemopneumothorax patient who was put on a chest tube insertion. It looked like 1500 cc of blood came out accompanied by an air component. Next, the chest tube is connected to the water-sealed drainage. The patient found a decrease in Hb from 15 mg/dl to 12 mg/dl. In the next nine hours, the patient's Hb became 10 mg/dl. As a result of this condition, the patient underwent an emergency thoracotomy to evaluate the source of bleeding, where the patient's source bleeding was found to be an arterial vein malformation (AVM) at the apex of the lung attached to the chest wall. Anatomical and pathological examination showed confirmed arterial vein malformation.&#x0D; Conclusion: Spontaneous hemopneumothorax, in this case, is a rare case caused by arterial-vein malformation. The right decision in patient management will determine the outcome and outcome of the treatment given.&#x0D;

Hemorrhagic pleural effusion in Indonesian male with pulmonary tuberculosis: A rare case.

BackgroundPatients with hemorrhagic pleural effusion who live in tuberculosis endemic areas are recommended to perform adenosine deaminase (ADA) test.Case presentationA Javanese 22-year-old male complained of shortness of breath and cough with phlegm for 1 week, and worsened 3 days before being admitted to the hospital. The X-ray results showed pleural effusion, and hemorrhagic pleural effusion examination showed an increase in lymphocytes (60.2%), lactate dehydrogenase/LDH (2624 U/L), and cell count (4584 cells/mm3), and the ADA test obtained 49 IU/L. The water-sealed drainage (WSD) was installed and first-line anti-tuberculosis drug (ATD) was given for 1 month. After showing improvement in the first month, the first-line ATD was continued until 6 months.DiscussionPatients with hemorrhage pleural effusion who live in tuberculosis endemic areas are recommended to perform differential diagnosis of hemorrhage pleural effusion and pulmonary tuberculosis. The use of the first-line ATD in hemorrhagic pleural effusion and pulmonary tuberculosis needs to be evaluated in the first month to detect improvement, otherwise, the medication is stopped and other investigations are carried out.ConclusionSuccessful management of hemorrhagic pleural effusion and pulmonary tuberculosis depends on early diagnosis.

INTERCOSTAL DRAIN -THE UNSUNG HERO OF THORACIC SURGERY

For post operative management after thoracic surgery(including cardiac surgery) or for management of chest trauma , chest tube with water seal drainage is essential ( and sometimes life saving ) because of unique physiology of thoracic cavity &amp; respiration . Only after knowing the physiology &amp; management of chest tube thoracic surgery could have advanced as of nowadays .

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study.

BackgroundUniportal video-assisted thoracoscopic surgery (UniVATS) was utilized with a rapid growth. The evidence is sparse, however, on whether to add external suction to water-seal drainage for chest drainage after UniVATS. This retrospective propensity score-matched study aimed to identify the necessity of adding external suction to chest drainage after UniVATS.MethodsPatients with lung cancer who underwent UniVATS were included from our prospectively maintained database. Patients were divided into two cohorts based on the addition of external suction to postoperative water-seal drainage or not. Propensity score-matched analysis was performed to identify the impact of suction on chest tube duration, incidence of persistent air leak, hospital stay, and hospitalization cost. Multivariable model with interaction terms was constructed to identify impact of covariables on effect of suction.ResultsThe two cohorts matched well on baseline characteristics (nonsuction: 173; suction: 96). Compared with nonsuction group, suction group showed longer median chest tube duration (3 vs. 2 days, p = 0.003), higher incidences of persistent air leak (9.4% vs. 1.2%, p = 0.003), persistent drainage (16.8% vs. 5.8%, p = 0.007), and reduced drainage volume within first 3 postoperative days (386.90 vs. 504.78 ml, p = 0.011). Resection extent was identified to mediate the relationship between suction and chest tube drainage.ConclusionsThese findings discouraged adding external suction to water-seal drainage after UniVATS regarding longer chest tube duration and more persistent air leak. Patients undergoing lobectomy would benefit more from water-seal drainage without external suction compared with those doing sublobectomy.

KNOWLEDGE OF STAFF NURSES REGARDING CARE OF PATIENT WITH CHEST TUBE DRAINAGE IN SELECTED HOSPITALS, KAMRUP (M), ASSAM.

Background of the study: Chest tube drainage which is also known as Under water seal drainage (UWSD), tube thoracotomy, or intercostal drainage, has a paramount importance in some emergencies or critical care situation. Inefcient nursing care or malfunction in chest tube drainage may associated with life threatening complications, or can be deadly for a patient in a matter of second. The aim of the study was to assess knowledge of staff Aim: nurses regarding care of patient with chest tube drainage. Method: Descriptive research design was adopted and 178 staff nurses working in ICU were selected by using non probability convenience sampling technique in selected hospitals, Kamrup (M), Assam and who fullls the inclusion criteria. It was found that majority 97(55%) of the Results: respondents had moderately adequate knowledge, 68(38%) respondents had inadequate knowledge, and 13(7%) had adequate knowledge. The mean and standard deviation of knowledge level is 15 and 4 respectively. The association was statistically tested by using Chi square at p≤0.001 level of signicance. The study shows that, out of 178 respondents, 68 (38%) had inadequate Conclusion: knowledge, 97 (55%) had moderately adequate knowledge and 13 (7%) had adequate knowledge regarding care of patient with chest tube drainage. So the investigator concluded that the in-service education in regular basis is very important for continuous learning.

Robotic transthoracic diaphragmatic hernia repair.

Robotic transthoracic diaphragmatic hernia repair.